Successful Management of Rhabdomyolysis with Acute Infection Resulting from Chronic Sacrococcygeal Pressure Ulcers in a Paraplegic Patient: A Case Report

Abstract

Background: Rhabdomyolysis, a potentially life-threatening syndrome, is caused by the breakdown of skeletal muscle cells and leakage of intramyocellular contents into the bloodstream. The treatment of cases with rhabdomyolysis resulting from chronic sacrococcygeal pressure ulcers have been rarely reported.Case presentation: A 62-year-old man suffered from high fever and dark-colored urine. For the past 30 years, the patient has lived with paraplegia, which led to his immobility. According to his physical examination, the wound on his sacrococcygeal region was dehisced and exuded repeatedly with loss of skin sensation. Upon corroboration of a physical examination and laboratory tests, the patient was diagnosed with rhabdomyolysis with an acute infection resulting from sacrococcygeal pressure ulcers. We first debrided the necrotic tissue, and then the chronic ulcer was repaired. The wound dressing was changed frequently, and antimicrobial therapy and nutritional support were included in the treatment. The fever and dark-colored urine were gradually relieved post-operatively. Renal function was also improved according to the typical indicators in laboratory tests. Additionally, the size of the pressure ulcers was reduced, to some extent. The patient was discharged after one month of hospitalization.Conclusions: Accurate diagnosis is critical for clinicians to administer precise treatment to paraplegic patients with progressive rhabdomyolysis.